1
|
Boekhorst F, Savona-Ventura C, Mahmood T, Mukhopadhyay S. The effects of climate change and environmental pollution on human reproduction: A scientific review commissioned by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstet Gynecol Reprod Biol 2024; 301:19-23. [PMID: 39084182 DOI: 10.1016/j.ejogrb.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
The European Board and College of Obstetrics and Gynaecology (EBCOG) and the European Network of Trainees in Obstetrics and Gynaecology (ENTOG) express their concerns on the effect of climate change and environmental pollution. This paper reviews the impact on reproductive health and the contribution to climate change by the field of obstetrics and gynaecology. It concludes that its contributors and the effects of climate change cause definite adverse consequences to fertility and adverse obstetric outcomes. Mankind, and obstetrics and gynaecology personnel as well, must be aware and responsible of its contribution to climate change and consider the impact of their actions and interventions.
Collapse
Affiliation(s)
- Ferry Boekhorst
- Department of Obstetrics and Gynaecology, Groene Hart Ziekenhuis, Gouda, the Netherlands
| | - Charles Savona-Ventura
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Surgery, University of Malta.
| | - Tahir Mahmood
- Spire Murrayfield Hospital, Edinburgh, Scotland, United Kingdom
| | | |
Collapse
|
2
|
Gupta J, Bai X, Liverman DM, Rockström J, Qin D, Stewart-Koster B, Rocha JC, Jacobson L, Abrams JF, Andersen LS, Armstrong McKay DI, Bala G, Bunn SE, Ciobanu D, DeClerck F, Ebi KL, Gifford L, Gordon C, Hasan S, Kanie N, Lenton TM, Loriani S, Mohamed A, Nakicenovic N, Obura D, Ospina D, Prodani K, Rammelt C, Sakschewski B, Scholtens J, Tharammal T, van Vuuren D, Verburg PH, Winkelmann R, Zimm C, Bennett E, Bjørn A, Bringezu S, Broadgate WJ, Bulkeley H, Crona B, Green PA, Hoff H, Huang L, Hurlbert M, Inoue CYA, Kılkış Ş, Lade SJ, Liu J, Nadeem I, Ndehedehe C, Okereke C, Otto IM, Pedde S, Pereira L, Schulte-Uebbing L, Tàbara JD, de Vries W, Whiteman G, Xiao C, Xu X, Zafra-Calvo N, Zhang X, Fezzigna P, Gentile G. A just world on a safe planet: a Lancet Planetary Health-Earth Commission report on Earth-system boundaries, translations, and transformations. Lancet Planet Health 2024:S2542-5196(24)00042-1. [PMID: 39276783 DOI: 10.1016/s2542-5196(24)00042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/09/2023] [Accepted: 03/08/2024] [Indexed: 09/17/2024]
Affiliation(s)
- Joyeeta Gupta
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands; IHE-Delft Institute for Water Education, Delft, Netherlands
| | - Xuemei Bai
- Fenner School of Environment & Society, Australian National University, Canberra, ACT, Australia
| | - Diana M Liverman
- School of Geography, Development and Environment, University of Arizona, Tucson, AZ, USA
| | - Johan Rockström
- Potsdam Institute for Climate Impact Research, Leibniz Association, Potsdam, Germany; Institute of Environmental Science and Geography, University of Potsdam, Potsdam, Germany
| | - Dahe Qin
- State Key Laboratory of Cryospheric Science, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, China; China Meteorological Administration, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Ben Stewart-Koster
- Australian Rivers Institute, Griffith University, Brisbane, QLD, Australia
| | - Juan C Rocha
- Future Earth Secretariat, Stockholm, Sweden; Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden.
| | | | - Jesse F Abrams
- Global Systems Institute, University of Exeter, Exeter, UK
| | - Lauren S Andersen
- Potsdam Institute for Climate Impact Research, Leibniz Association, Potsdam, Germany
| | - David I Armstrong McKay
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden; Global Systems Institute, University of Exeter, Exeter, UK; Georesilience Analytics, Leatherhead, UK
| | - Govindasamy Bala
- Center for Atmospheric and Oceanic Sciences, Indian Institute of Science, Bengaluru, India
| | - Stuart E Bunn
- Australian Rivers Institute, Griffith University, Brisbane, QLD, Australia
| | - Daniel Ciobanu
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Fabrice DeClerck
- EAT, Oslo, Norway; Alliance of Bioversity and CIAT, CGIAR, Montpellier, France
| | - Kristie L Ebi
- Center for Health & the Global Environment, University of Washington, Seattle, WA, USA
| | - Lauren Gifford
- School of Geography, Development and Environment, University of Arizona, Tucson, AZ, USA
| | - Christopher Gordon
- Institute for Environment and Sanitation Studies, University of Ghana, Legon, Ghana
| | - Syezlin Hasan
- Australian Rivers Institute, Griffith University, Brisbane, QLD, Australia
| | - Norichika Kanie
- Graduate School of Media and Governance, Keio University, Fujisawa, Japan
| | | | - Sina Loriani
- Potsdam Institute for Climate Impact Research, Leibniz Association, Potsdam, Germany
| | - Awaz Mohamed
- Functional Forest Ecology, University of Hamburg, Hamburg, Germany
| | | | - David Obura
- Coastal Oceans Research and Development in the Indian Ocean East Africa, Mombasa, Kenya
| | | | - Klaudia Prodani
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Crelis Rammelt
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Boris Sakschewski
- Potsdam Institute for Climate Impact Research, Leibniz Association, Potsdam, Germany
| | - Joeri Scholtens
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Thejna Tharammal
- Interdisciplinary Centre for Water Research, Indian Institute of Science, Bengaluru, India
| | - Detlef van Vuuren
- Copernicus Institute of Sustainable Development, Utrecht University, Utrecht, Netherlands; PBL Netherlands Environmental Assessment Agency, The Hague, Netherlands
| | - Peter H Verburg
- Swiss Federal Institute for Forest, Snow and Landscape Research, Birmensdorf, Switzerland; Institute for Environmental Studies, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ricarda Winkelmann
- Potsdam Institute for Climate Impact Research, Leibniz Association, Potsdam, Germany; Institute of Physics and Astronomy, University of Potsdam, Potsdam, Germany
| | - Caroline Zimm
- International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Elena Bennett
- Bieler School of Environment and Department of Natural Resource Sciences, McGill University, Montreal, QC, Canada
| | - Anders Bjørn
- Centre for Absolute Sustainability and Section for Quantitative Sustainability Assessment, Department of Environmental and Resource Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Stefan Bringezu
- Center for Environmental Systems Research, University of Kassel, Kassel, Germany
| | | | - Harriet Bulkeley
- Copernicus Institute of Sustainable Development, Utrecht University, Utrecht, Netherlands; Department of Geography, Durham University, Durham, UK
| | - Beatrice Crona
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden; Global Economic Dynamics and the Biosphere Programme, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Pamela A Green
- Advanced Science Research Center at the Graduate Center, City University of New York, NY, USA
| | - Holger Hoff
- Wegener Center for Climate and Global Change, University of Graz, Graz, Austria
| | - Lei Huang
- National Climate Center, Beijing, China
| | - Margot Hurlbert
- Johnson-Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
| | - Cristina Y A Inoue
- Center for Global Studies, Institute of International Relations, University of Brasília, Brasília, Brazil; Institute for Management Research, Radboud University, Nijmegen, Netherlands
| | - Şiir Kılkış
- Scientific and Technological Research Council of Turkey, Ankara, Türkiye
| | - Steven J Lade
- Fenner School of Environment & Society, Australian National University, Canberra, ACT, Australia; Future Earth Secretariat, Stockholm, Sweden; Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Jianguo Liu
- Center for Systems Integration and Sustainability, Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
| | - Imran Nadeem
- Institute of Meteorology and Climatology, Department of Ecosystem Management, Climate and Biodiversity, BOKU University, Vienna, Austria
| | - Christopher Ndehedehe
- Australian Rivers Institute, Griffith University, Brisbane, QLD, Australia; School of Environment & Science, Griffith University, Nathan, QLD, Australia
| | | | - Ilona M Otto
- Wegener Center for Climate and Global Change, University of Graz, Graz, Austria
| | - Simona Pedde
- Future Earth Secretariat, Stockholm, Sweden; Soil raphy and Landscape Group, Wageningen University & Research, Wageningen, Netherlands
| | - Laura Pereira
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden; Global Change Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Lena Schulte-Uebbing
- PBL Netherlands Environmental Assessment Agency, The Hague, Netherlands; Environmental Systems Analysis Group, Wageningen University & Research, Wageningen, Netherlands
| | - J David Tàbara
- Autonomous University of Barcelona, Barcelona, Spain; Global Climate Forum, Berlin, Germany
| | - Wim de Vries
- Environmental Systems Analysis Group, Wageningen University & Research, Wageningen, Netherlands
| | | | - Cunde Xiao
- State Key Laboratory of Cryospheric Science, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, China; State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China
| | - Xinwu Xu
- China Meteorological Administration, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Noelia Zafra-Calvo
- Basque Centre for Climate Change, Scientific Campus of the University of the Basque Country, Biscay, Spain
| | - Xin Zhang
- Appalachian Laboratory, University of Maryland Center for Environmental Science, Frostburg, MD, USA
| | - Paola Fezzigna
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Giuliana Gentile
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
3
|
Maloney SK, Kearney MR, Mitchell D. Indices of human heat stress in times of climate change. Acta Physiol (Oxf) 2024; 240:e14196. [PMID: 38953744 DOI: 10.1111/apha.14196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Affiliation(s)
- Shane K Maloney
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Brain Function Research Group, School of Physiology, The University of the Witwatersrand, Johannesburg, South Africa
| | - Michael R Kearney
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Duncan Mitchell
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Brain Function Research Group, School of Physiology, The University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Leach OK, Cottle RM, Fisher KG, Wolf ST, Kenney WL. Sex differences in heat stress vulnerability among middle-aged and older adults (PSU HEAT Project). Am J Physiol Regul Integr Comp Physiol 2024; 327:R320-R327. [PMID: 39005081 DOI: 10.1152/ajpregu.00114.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024]
Abstract
Individuals over the age of 65 yr are the most vulnerable population during severe environmental heat events, experiencing worse health outcomes than any other age cohort. The risk is greater in older women than in age-matched men; however, whether that reflects a greater susceptibility to heat in women, or simply population sex proportionality, is unclear. Seventy-two participants (29 M/43 F) aged 40-92 yr were exposed to progressive heat stress at a metabolic rate designed to reflect activities of daily living. Experiments were conducted in both hot-dry (HD; up to 53°C; ≤25% rh) and warm-humid (WH; ∼35°C; ≥50% rh) environments. After critical limits were determined for each condition, forward stepwise multiple linear regression analyses were conducted with net metabolic rate (Mnet) and age entered into the model first, followed by sex, body mass (mb), maximal oxygen consumption (V̇o2max), body surface area, and LDL cholesterol. After accounting for Mnet and age, sex further improved the regression model in the HD environment ([Formula: see text] = 0.34, P < 0.001) and the WH environment ([Formula: see text] = 0.36, P < 0.005). Sex explained ∼15% of the variance in critical environmental limits in HD conditions and 12% in WH conditions. Heat compensability curves were shifted leftward for older women, indicating age- and sex-dependent heat vulnerability compared with middle-aged women and older men in WH (P = 0.007, P = 0.03) and HD (P = 0.001, P = 0.01) environments. This reflects the heterogeneity of thermal-balance thresholds associated with aging relative to those seen in young adults and suggests that older females are more vulnerable than their age-matched male counterparts.NEW & NOTEWORTHY In contrast to young adults, there are sex differences in critical environmental limits in middle-aged and older adults. Older women exhibit lower critical environmental limits in both humid and dry extreme environments demonstrated by a leftward shift in heat compensability curves. These data confirm a true sex difference in heat vulnerability of older adults and support the epidemiological mortality data from environmental heat waves.
Collapse
Affiliation(s)
- Olivia K Leach
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Rachel M Cottle
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Kat G Fisher
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - S Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - W Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, United States
- Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| |
Collapse
|
5
|
Raines K, Fitchett JM. Exploring the risk of heat stress in high school pre-season sports training, Johannesburg, South Africa. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02748-9. [PMID: 39141135 DOI: 10.1007/s00484-024-02748-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 07/24/2024] [Accepted: 07/28/2024] [Indexed: 08/15/2024]
Abstract
There is growing concern over the increased risk of heat stress induced by the changing climate, with increased global temperatures expected to exacerbate conditions. Heat stress in school sports is a critically understudied research area in South Africa (SA). As demonstrated by several studies conducted in the global north, the stress elicited by meteorological conditions on students participating in physical education lessons and after-school sports activities could have serious consequences on their health. This paper represents the first research in the region to investigate the risk of heat stress to school students during physical activity. Meteorological data were collected at a school in Johannesburg between March and July, which encompasses the seasons of late summer, autumn, and winter. These were inputted into four heat stress indices: Humidex, Heat Index, Wet Bulb Globe Temperature, and the Universal Thermal Climate Index, together with the measured Wet Bulb Temperature to determine the level of risk of heat stress during physical education lessons and after-school sports activities between March and July. Of the 2700 index scores calculated over this period, 56% indicate some level of heat stress, with almost 6% indicating a high and very high level of risk. Heat stress is calculated to be most likely to occur between 11h00-15h00, and the danger of pre-season training, which takes place in the summer months, is demonstrated by these results. Additionally, this research finds that heat stress is far more likely on artificial surfaces than on natural grass. The findings of this research intimate that school stakeholders should consider the implications of heat stress when considering timetabling and policy-making in the interests of safeguarding their students.
Collapse
Affiliation(s)
- Kayleigh Raines
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Private Bag X3, Wits, 2050, South Africa
| | - Jennifer M Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Private Bag X3, Wits, 2050, South Africa.
| |
Collapse
|
6
|
Guo Q, Mistry MN, Zhou X, Zhao G, Kino K, Wen B, Yoshimura K, Satoh Y, Cvijanovic I, Kim Y, Ng CFS, Vicedo-Cabrera AM, Armstrong B, Urban A, Katsouyanni K, Masselot P, Tong S, Sera F, Huber V, Bell ML, Kyselý J, Gasparrini A, Hashizume M, Oki T. Regional variation in the role of humidity on city-level heat-related mortality. PNAS NEXUS 2024; 3:pgae290. [PMID: 39114575 PMCID: PMC11305137 DOI: 10.1093/pnasnexus/pgae290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024]
Abstract
The rising humid heat is regarded as a severe threat to human survivability, but the proper integration of humid heat into heat-health alerts is still being explored. Using state-of-the-art epidemiological and climatological datasets, we examined the association between multiple heat stress indicators (HSIs) and daily human mortality in 739 cities worldwide. Notable differences were observed in the long-term trends and timing of heat events detected by HSIs. Air temperature (Tair) predicts heat-related mortality well in cities with a robust negative Tair-relative humidity correlation (CT-RH). However, in cities with near-zero or weak positive CT-RH, HSIs considering humidity provide enhanced predictive power compared to Tair. Furthermore, the magnitude and timing of heat-related mortality measured by HSIs could differ largely from those associated with Tair in many cities. Our findings provide important insights into specific regions where humans are vulnerable to humid heat and can facilitate the further enhancement of heat-health alert systems.
Collapse
Affiliation(s)
- Qiang Guo
- Department of Civil Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505, Japan
| | - Malcolm N Mistry
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
- Department of Economics, Ca’ Foscari University of Venice, San Giobbe, Cannaregio 873, Venice 30121, Italy
| | - Xudong Zhou
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505, Japan
- Institute of Hydraulics and Ocean Engineering, Ningbo University, 818 Fenghua Road, Ningbo 315211, China
| | - Gang Zhao
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505, Japan
| | - Kanon Kino
- Department of Civil Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Kei Yoshimura
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505, Japan
| | - Yusuke Satoh
- Moon Soul Graduate School of Future Strategy, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Ivana Cvijanovic
- Barcelona Institute for Global Health—ISGLOBAL, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Hochschulstrasse 4, Bern 3012, Switzerland
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, Prague 141 31, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, Prague 165 00, Czech Republic
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
- Environmental Research Group, School of Public Health, Imperial College London, White City Campus, Wood Lane, London W12 0BZ, United Kingdom
| | - Pierre Masselot
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Rd, Kelvin Grove, Brisbane QLD 4059, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, 1678 East Road, Shanghai 200127, China
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications “G. Parenti”, University of Florence, Viale Morgagni, 59, Florence 50134, Italy
| | - Veronika Huber
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - Michelle L Bell
- School of the Environment, Yale University, 195 Prospect Street, New Haven, CT 06511, USA
- School of Health Policy and Management, College of Health Sciences, Korea University, B-dong Hana-Science Building, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, Prague 141 31, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, Prague 165 00, Czech Republic
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Taikan Oki
- Department of Civil Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| |
Collapse
|
7
|
Wong C. What is the hottest temperature humans can survive? These labs are redefining the limit. Nature 2024; 632:713-715. [PMID: 39143288 DOI: 10.1038/d41586-024-02422-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
|
8
|
Sivaraj S, Zscheischler J, Buzan JR, Martius O, Brönnimann S, Vicedo-Cabrera AM. Heat, humidity and health impacts: how causal diagrams can help tell the complex story. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2024; 19:074069. [PMID: 39070017 PMCID: PMC7616305 DOI: 10.1088/1748-9326/ad5a25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
The global health burden associated with exposure to heat is a grave concern and is projected to further increase under climate change. While physiological studies have demonstrated the role of humidity alongside temperature in exacerbating heat stress for humans, epidemiological findings remain conflicted. Understanding the intricate relationships between heat, humidity, and health outcomes is crucial to inform adaptation and drive increased global climate change mitigation efforts. This article introduces 'directed acyclic graphs' (DAGs) as causal models to elucidate the analytical complexity in observational epidemiological studies that focus on humid-heat-related health impacts. DAGs are employed to delineate implicit assumptions often overlooked in such studies, depicting humidity as a confounder, mediator, or an effect modifier. We also discuss complexities arising from using composite indices, such as wet-bulb temperature. DAGs representing the health impacts associated with wet-bulb temperature help to understand the limitations in separating the individual effect of humidity from the perceived effect of wet-bulb temperature on health. General examples for regression models corresponding to each of the causal assumptions are also discussed. Our goal is not to prioritize one causal model but to discuss the causal models suitable for representing humid-heat health impacts and highlight the implications of selecting one model over another. We anticipate that the article will pave the way for future quantitative studies on the topic and motivate researchers to explicitly characterize the assumptions underlying their models with DAGs, facilitating accurate interpretations of the findings. This methodology is applicable to similarly complex compound events.
Collapse
Affiliation(s)
- Sidharth Sivaraj
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Jakob Zscheischler
- Department of Compound Environmental Risks, Helmholtz Centre for Environmental Research—UFZ, Leipzig, Germany
- Technische Universität Dresden, Dresden, Germany
| | - Jonathan R Buzan
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
- Physics Institute, University of Bern, Bern, Switzerland
| | - Olivia Martius
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
- Institute of Geography, University of Bern, Bern, Switzerland
| | - Stefan Brönnimann
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
- Institute of Geography, University of Bern, Bern, Switzerland
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| |
Collapse
|
9
|
Matte T, Lane K, Tipaldo JF, Barnes J, Knowlton K, Torem E, Anand G, Yoon L, Marcotullio P, Balk D, Constible J, Elszasz H, Ito K, Jessel S, Limaye V, Parks R, Rutigliano M, Sorenson C, Yuan A. NPCC4: Climate change and New York City's health risk. Ann N Y Acad Sci 2024. [PMID: 38922909 DOI: 10.1111/nyas.15115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 06/28/2024]
Abstract
This chapter of the New York City Panel on Climate Change 4 (NPCC4) report considers climate health risks, vulnerabilities, and resilience strategies in New York City's unique urban context. It updates evidence since the last health assessment in 2015 as part of NPCC2 and addresses climate health risks and vulnerabilities that have emerged as especially salient to NYC since 2015. Climate health risks from heat and flooding are emphasized. In addition, other climate-sensitive exposures harmful to human health are considered, including outdoor and indoor air pollution, including aeroallergens; insect vectors of human illness; waterborne infectious and chemical contaminants; and compounding of climate health risks with other public health emergencies, such as the COVID-19 pandemic. Evidence-informed strategies for reducing future climate risks to health are considered.
Collapse
Affiliation(s)
- Thomas Matte
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Kathryn Lane
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Jenna F Tipaldo
- CUNY Graduate School of Public Health and Health Policy and CUNY Institute for Demographic Research, New York, New York, USA
| | - Janice Barnes
- Climate Adaptation Partners, New York, New York, USA
| | - Kim Knowlton
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Emily Torem
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Gowri Anand
- City of New York, Department of Transportation, New York, New York, USA
| | - Liv Yoon
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Peter Marcotullio
- Department of Geography and Environmental Science, Hunter College, CUNY, New York, New York, USA
| | - Deborah Balk
- Marxe School of Public and International Affairs, Baruch College and also CUNY Institute for Demographic Research, New York, New York, USA
| | | | - Hayley Elszasz
- City of New York, Mayors Office of Climate and Environmental Justice, New York, New York, USA
| | - Kazuhiko Ito
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Sonal Jessel
- WE ACT for Environmental Justice, New York, New York, USA
| | - Vijay Limaye
- Natural Resources Defense Council, New York, New York, USA
| | - Robbie Parks
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Mallory Rutigliano
- New York City Mayor's Office of Management and Budget, New York, New York, USA
| | - Cecilia Sorenson
- Mailman School of Public Health, Columbia University, New York, New York, USA
- Global Consortium on Climate and Health Education, Columbia University, New York, New York, USA
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ariel Yuan
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| |
Collapse
|
10
|
Yezli S, Ehaideb S, Yassin Y, Alotaibi B, Bouchama A. Escalating climate-related health risks for Hajj pilgrims to Mecca. J Travel Med 2024; 31:taae042. [PMID: 38457640 PMCID: PMC11149718 DOI: 10.1093/jtm/taae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/02/2024] [Accepted: 03/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Global temperatures are on the rise, leading to more frequent and severe heatwaves with associated health risks. Heat-related illnesses (HRIs) are an increasing threat for travellers to hot climate destinations. This study was designed to elucidate the interplay between increasing ambient temperatures, incidence of HRIs and the effectiveness of mitigation strategies during the annual Hajj mass gathering over a 40-year period. METHODS An observational study was conducted utilizing historical records spanning four decades of meteorological data, and the rates of heat stroke (HS) and heat exhaustion (HE) during the Hajj pilgrimage in Mecca, Saudi Arabia. With an annual population exceeding 2 million participants from over 180 countries, the study analysed temporal variations in weather conditions over two distinct Hajj hot cycles and correlated it with the occurrence of HS and HE. The effectiveness of deployed mitigation measures in alleviating health vulnerabilities between the two cycles was also assessed. RESULTS Throughout the study period, average dry and wet bulb temperatures in Mecca escalated by 0.4°C (Mann-Kendall P < 0.0001) and 0.2°C (Mann-Kendall P = 0.25) per decade, respectively. Both temperatures were strongly correlated with the incidence of HS and HE (P < 0.001). Despite the intensifying heat, the mitigation strategies including individual, structural and community measures were associated with a substantial 74.6% reduction in HS cases and a 47.6% decrease in case fatality rate. CONCLUSION The study underscores the escalating climate-related health risks in Mecca over the study period. The mitigation measures' efficacy in such a globally representative setting emphasizes the findings' generalizability and the importance of refining public health interventions in the face of rising temperatures.
Collapse
Affiliation(s)
- Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia
| | - Salleh Ehaideb
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Yara Yassin
- Federation of Saudi Chambers Institute, Federation of Saudi Chambers, Riyadh 12711, Saudi Arabia
| | | | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| |
Collapse
|
11
|
Vecellio DJ, Vanos JK. Aligning thermal physiology and biometeorological research for heat adaptation and resilience in a changing climate. J Appl Physiol (1985) 2024; 136:1322-1328. [PMID: 38385187 PMCID: PMC11365541 DOI: 10.1152/japplphysiol.00098.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Daniel J Vecellio
- Center for Healthy Aging, Pennsylvania State University, University Park, Pennsylvania, United States
- Virginia Climate Center, George Mason University, Fairfax, Virginia, United States
| | - Jennifer K Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona, United States
| |
Collapse
|
12
|
Filingeri D, Valenza A, Ficarra S, Filingeri V, Worsley PR, Bianco A. A case report on the physiological responses to extreme heat during Sicily's July 2023 heatwave. Physiol Rep 2024; 12:e16107. [PMID: 38849294 PMCID: PMC11161270 DOI: 10.14814/phy2.16107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
July 2023 has been confirmed as Earth's hottest month on record, and it was characterized by extraordinary heatwaves across southern Europe. Field data collected under real heatwave periods could add important evidence to understand human adaptability to extreme heat. However, field studies on human physiological responses to heatwave periods remain limited. We performed field thermo-physiological measurements in a healthy 37-years male undergoing resting and physical activity in an outdoor environment in the capital of Sicily, Palermo, during (July 21; highest level of local heat-health alert) and following (August 10; lowest level of local heat-health alert) the peak of Sicily's July 2023 heatwave. Results indicated that ~40 min of outdoor walking and light running in 33.8°C Wet Bulb Globe Temperature (WBGT) conditions (July 21) resulted in significant physiological stress (i.e., peak heart rate: 209 bpm; core temperature: 39.13°C; mean skin temperature: 37.2°C; whole-body sweat losses: 1.7 kg). Importantly, significant physiological stress was also observed during less severe heat conditions (August 10; WBGT: 29.1°C; peak heart rate: 190 bpm; core temperature: 38.48°C; whole-body sweat losses: 2 kg). These observations highlight the physiological strain that current heatwave conditions pose on healthy young individuals. This ecologically-valid empirical evidence could inform more accurate heat-health planning.
Collapse
Affiliation(s)
- Davide Filingeri
- ThermosenseLab, Skin Sensing Research Group, School of Health SciencesThe University of SouthamptonSouthamptonUK
| | - Alessandro Valenza
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Victoria Filingeri
- Psychological and Behavioural Sciences, School of Psychology, College of Health, Psychology and Social CareUniversity of DerbyDerbyUK
| | - Peter R. Worsley
- PRESSURELAB, Skin Sensing Research Group, School of Health SciencesThe University of SouthamptonSouthamptonUK
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| |
Collapse
|
13
|
Wang F, Gao M, Liu C, Zhao R, McElroy MB. Uniformly elevated future heat stress in China driven by spatially heterogeneous water vapor changes. Nat Commun 2024; 15:4522. [PMID: 38806500 PMCID: PMC11133461 DOI: 10.1038/s41467-024-48895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/16/2024] [Indexed: 05/30/2024] Open
Abstract
The wet bulb temperature (Tw) has gained considerable attention as a crucial indicator of heat-related health risks. Here we report south-to-north spatially heterogeneous trends of Tw in China over 1979-2018. We find that actual water vapor pressure (Ea) changes play a dominant role in determining the different trend of Tw in southern and northern China, which is attributed to the faster warming of high-latitude regions of East Asia as a response to climate change. This warming effect regulates large-scale atmospheric features and leads to extended impacts of the South Asia high (SAH) and the western Pacific subtropical high (WPSH) over southern China and to suppressed moisture transport. Attribution analysis using climate model simulations confirms these findings. We further find that the entire eastern China, that accommodates 94% of the country's population, is likely to experience widespread and uniform elevated thermal stress the end of this century. Our findings highlight the necessity for development of adaptation measures in eastern China to avoid adverse impacts of heat stress, suggesting similar implications for other regions as well.
Collapse
Affiliation(s)
- Fan Wang
- Department of Geography, Hong Kong Baptist University, Kowloon Tong, 999077, Hong Kong SAR, China
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Kowloon Tong, 999077, Hong Kong SAR, China.
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA.
| | - Cheng Liu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, 230026, China.
- Key Laboratory of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Hefei, 230031, China.
| | - Ran Zhao
- Key Laboratory of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Hefei, 230031, China
- School of Environmental Science and Optoelectronic Technology, University of Science and Technology of China, Hefei, 230026, China
| | - Michael B McElroy
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
| |
Collapse
|
14
|
Xu X, Rioux TP, Welles AP, Jay O, Ely BR, Charkoudian N. Modeling thermoregulatory responses during high-intensity exercise in warm environments. J Appl Physiol (1985) 2024; 136:908-916. [PMID: 38385185 DOI: 10.1152/japplphysiol.00873.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
The six cylinder thermoregulatory model (SCTM) has been validated thoroughly for resting humans. This type of modeling is helpful to predict and develop guidance for safe performance of work and recreational activities. In the context of a warming global climate, updating the accuracy of the model for intense exercise in warm environments will help a wide range of individuals in athletic, recreational, and military settings. Three sets of previously collected data were used to determine SCTM accuracy. Dataset 1: two groups [large (LG) 91.5 kg and small (SM) 67.7 kg] of individuals performed 60 min of semirecumbent cycling in temperate conditions (25.1°C) at metabolic rates of 570-700 W. Dataset 2: two LG (100 kg) and SM (65.8 kg) groups performed 60 min of semirecumbent cycling in warm/hot environmental conditions (36.2°C) at metabolic rates of 590-680 W. Dataset 3: seven volunteers completed 8-km track trials (∼30 min) in cool (17°C) and warm (30°C) environments. The volunteers' metabolic rates were estimated to be 1,268 W and 1,166 W, respectively. For all datasets, SCTM-predicted core temperatures were found to be similar to the observed core temperatures. The root mean square deviations (RMSDs) ranged from 0.06 to 0.46°C with an average of 0.2°C deviation, which is less than the acceptance threshold of 0.5°C. Thus, the present validation shows that SCTM predicts core temperatures with acceptable accuracy during intense exercise in warm environments and successfully captures core temperature differences between large and small individuals.NEW & NOTEWORTHY The SCTM has been validated thoroughly for resting humans in warm and cold environments and during water immersion. The present study further demonstrated that SCTM predicts core temperatures with acceptable accuracy during intense exercise up to 1,300 W in temperate and warm environments and captures core temperature differences between large and small individuals. SCTM is potentially useful to develop guidance for safe operation in athletic, military, and occupational settings during exposure to warm or hot environments.
Collapse
Affiliation(s)
- Xiaojiang Xu
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Timothy P Rioux
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Alexander P Welles
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Brett R Ely
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
- School of Nursing & Health Sciences, Providence College, Providence, Rhode Island, United States
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| |
Collapse
|
15
|
Muccione V, Biesbroek R, Harper S, Haasnoot M. Towards a more integrated research framework for heat-related health risks and adaptation. Lancet Planet Health 2024; 8:e61-e67. [PMID: 38199725 DOI: 10.1016/s2542-5196(23)00254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 01/12/2024]
Abstract
Advances in research on current and projected heat-related risks from climate change and the associated responses have rapidly developed over the past decade. Modelling architectures of climate impacts and heat-related health risks have become increasingly sophisticated alongside a growing number of experiments and socioeconomic studies, and possible options for heat-related health adaptation are increasingly being catalogued and assessed. However, despite this progress, these efforts often remain isolated streams of research, substantially hampering our ability to contribute to evidence-informed decision making on responding to heat-related health risks. We argue that the integration of scientific efforts towards more holistic research is urgently needed to tackle fragmented evidence and identify crucial knowledge gaps, so that health research can better anticipate and respond to heat-related health risks in the context of a changing climate. In this Personal View, we outline six building blocks, each constituting a research stream, but each needed as part of a more integrated research framework-namely, projected heat-related health risks; adaptation options; the feasibility and effectiveness of adaptation; synergies, trade-offs, and co-benefits of adaptation; adaptation limits and residual risks; and adaptation pathways. We outline their respective importance and discuss their benefits for health-related research and policy.
Collapse
Affiliation(s)
- Veruska Muccione
- Department of Geography, University of Zurich, Zurich, Switzerland; Swiss Federal Research Institute WSL, Birmensdorf, Switzerland.
| | - Robbert Biesbroek
- Public Administration and Policy Group, Wageningen University, Wageningen, Netherlands
| | - Sherilee Harper
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Marjolijn Haasnoot
- Deltares, Delft, Netherlands; Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
16
|
Pandipati S, Leong M, Basu R, Abel D, Hayer S, Conry J. Climate change: Overview of risks to pregnant persons and their offspring. Semin Perinatol 2023; 47:151836. [PMID: 37863676 DOI: 10.1016/j.semperi.2023.151836] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Climate change is one of the greatest challenges confronting humanity. Pregnant persons, their unborn children, and offspring are particularly vulnerable, as evidenced by adverse perinatal outcomes and increased rates of childhood illnesses. Environmental inequities compound the problem of maternal health inequities, and have given rise to the environmental justice movement. The International Federation of Gynecology and Obstetrics and other major medical societies have worked to heighten awareness and address the deleterious health effects of climate change and toxic environmental exposures. As part of routine prenatal, neonatal, and pediatric care, neonatal-perinatal care providers should incorporate discussions with their patients and families on potential harms and also identify actions to mitigate climate change effects on their health. This article provides clinicians with an overview of how climate change affects their patients, practical guidance in caring for them, and a frame setting of the articles to follow. Clinicians have a critical role to play, and the time to act is now.
Collapse
Affiliation(s)
- Santosh Pandipati
- Maternal-Fetal Medicine, Obstetrix of San Jose, e-Lōvu Health, United States.
| | - Melanie Leong
- Attending Neonatologist, Neonatal ECMO Services, The Regional Neonatal Center of Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, United States; Assistant Professor of Pediatrics, New York Medical College, United States
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California EPA, United States
| | - David Abel
- Maternal-Fetal Medicine, Oregon Health Sciences University, United States
| | - Sarena Hayer
- Obstetrics & Gynecology, Oregon Health Sciences University, United States
| | - Jeanne Conry
- International Federation of Gynecology and Obstetrics, United States
| |
Collapse
|
17
|
Vanos J, Guzman-Echavarria G, Baldwin JW, Bongers C, Ebi KL, Jay O. A physiological approach for assessing human survivability and liveability to heat in a changing climate. Nat Commun 2023; 14:7653. [PMID: 38030628 PMCID: PMC10687011 DOI: 10.1038/s41467-023-43121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Most studies projecting human survivability limits to extreme heat with climate change use a 35 °C wet-bulb temperature (Tw) threshold without integrating variations in human physiology. This study applies physiological and biophysical principles for young and older adults, in sun or shade, to improve current estimates of survivability and introduce liveability (maximum safe, sustained activity) under current and future climates. Our physiology-based survival limits show a vast underestimation of risks by the 35 °C Tw model in hot-dry conditions. Updated survivability limits correspond to Tw~25.8-34.1 °C (young) and ~21.9-33.7 °C (old)-0.9-13.1 °C lower than Tw = 35 °C. For older female adults, estimates are ~7.2-13.1 °C lower than 35 °C in dry conditions. Liveability declines with sun exposure and humidity, yet most dramatically with age (2.5-3.0 METs lower for older adults). Reductions in safe activity for younger and older adults between the present and future indicate a stronger impact from aging than warming.
Collapse
Affiliation(s)
- Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA.
| | - Gisel Guzman-Echavarria
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Jane W Baldwin
- Department of Earth System Science, University of California Irvine, Irvine, CA, USA
- Lamont-Doherty Earth Observatory, Palisades, NY, USA
| | - Coen Bongers
- Department of Medical Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
18
|
Koch M, Matzke I, Huhn S, Sié A, Boudo V, Compaoré G, Maggioni MA, Bunker A, Bärnighausen T, Dambach P, Barteit S. Assessing the Effect of Extreme Weather on Population Health Using Consumer-Grade Wearables in Rural Burkina Faso: Observational Panel Study. JMIR Mhealth Uhealth 2023; 11:e46980. [PMID: 37938879 PMCID: PMC10666008 DOI: 10.2196/46980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Extreme weather, including heat and extreme rainfall, is projected to increase owing to climate change, which can have adverse impacts on human health. In particular, rural populations in sub-Saharan Africa are at risk because of a high burden of climate-sensitive diseases and low adaptive capacities. However, there is a lack of data on the regions that are anticipated to be most exposed to climate change. Improved public health surveillance is essential for better decision-making and health prioritization and to identify risk groups and suitable adaptation measures. Digital technologies such as consumer-grade wearable devices (wearables) may generate objective measurements to guide data-driven decision-making. OBJECTIVE The main objective of this observational study was to examine the impact of weather exposure on population health in rural Burkina Faso using wearables. Specifically, this study aimed to assess the relationship between individual daily activity (steps), sleep duration, and heart rate (HR), as estimated by wearables, and exposure to heat and heavy rainfall. METHODS Overall, 143 participants from the Nouna health and demographic surveillance system in Burkina Faso wore the Withings Pulse HR wearable 24/7 for 11 months. We collected continuous weather data using 5 weather stations throughout the study region. The heat index and wet-bulb globe temperature (WBGT) were calculated as measures of heat. We used linear mixed-effects models to quantify the relationship between exposure to heat and rainfall and the wearable parameters. Participants kept activity journals and completed a questionnaire on their perception of and adaptation to heat and other weather exposure. RESULTS Sleep duration decreased significantly (P<.001) with higher heat exposure, with approximately 15 minutes shorter sleep duration during heat stress nights with a heat index value of ≥25 °C. Many participants (55/137, 40.1%) reported that heat affected them the most at night. During the day, most participants (133/137, 97.1%) engaged in outdoor physical work such as farming, housework, or fetching water. During the rainy season, when WBGT was highest, daily activity was highest and increased when the daily maximum WBGT surpassed 30 °C during the rainiest month. In the hottest month, daily activity decreased per degree increase in WBGT for values >30 °C. Nighttime HR showed no significant correlation with heat exposure. Daytime HR data were insufficient for analysis. We found no negative health impact associated with heavy rainfall. With increasing rainfall, sleep duration increased, average nightly HR decreased, and activity decreased. CONCLUSIONS During the study period, participants were frequently exposed to heat and heavy rainfall. Heat was particularly associated with impaired sleep and daily activity. Essential tasks such as harvesting, fetching water, and caring for livestock expose this population to weather that likely has an adverse impact on their health. Further research is essential to guide interventions safeguarding vulnerable communities.
Collapse
Affiliation(s)
- Mara Koch
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ina Matzke
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sophie Huhn
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ali Sié
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | | | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Aditi Bunker
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
- Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Peter Dambach
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Faculty of Medicine, University Hospital, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
19
|
Çelebi Sözener Z, Treffeisen ER, Özdel Öztürk B, Schneider LC. Global warming and implications for epithelial barrier disruption and respiratory and dermatologic allergic diseases. J Allergy Clin Immunol 2023; 152:1033-1046. [PMID: 37689250 PMCID: PMC10864040 DOI: 10.1016/j.jaci.2023.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the airway epithelial barrier by disrupting the structural proteins and by triggering airway inflammation and hyperreactivity. It enhances tidal volume and respiratory rate by affecting the thermoregulatory system, causing specific airway resistance and reflex bronchoconstriction via activation of bronchopulmonary vagal C fibers and upregulation of transient receptor potential vanilloid (TRPV) 1 and TRPV4. Heat shock proteins are activated under heat stress and contribute to both epithelial barrier dysfunction and airway inflammation. Accordingly, the frequency and severity of allergic rhinitis and asthma have been increasing. Heat activates TRPV3 in keratinocytes, causing the secretion of inflammatory mediators and eventually pruritus. Exposure to air pollutants alters the expression of genes that control skin barrier integrity and triggers an immune response, increasing the incidence and prevalence of atopic dermatitis. There is evidence that extreme temperature, heavy rains and floods, air pollution, and wildfires increase atopic dermatitis flares. In this narrative review, focused on the last 3 years of literature, we explore the effects of global warming on respiratory and skin barrier and their clinical consequences.
Collapse
Affiliation(s)
- Zeynep Çelebi Sözener
- Division of Immunology and Allergic Diseases, Ankara Bilkent City Hospital, Ankara, Turkey.
| | - Elsa R Treffeisen
- Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Betül Özdel Öztürk
- Division of Immunology and Allergic Diseases, Bolu Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Lynda C Schneider
- Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| |
Collapse
|
20
|
Sherwood SC, Ramsay EE. Closer limits to human tolerance of global heat. Proc Natl Acad Sci U S A 2023; 120:e2316003120. [PMID: 37831746 PMCID: PMC10614209 DOI: 10.1073/pnas.2316003120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023] Open
Affiliation(s)
- Steven C. Sherwood
- Climate Change Research Centre, University of New South Wales, Sydney, NSW2052, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW2052, Australia
| | - Emma E. Ramsay
- Asian School of the Environment and Earth Observatory of Singapore, Nanyang Technological University, Singapore639798, Singapore
| |
Collapse
|
21
|
Vecellio DJ, Kong Q, Kenney WL, Huber M. Greatly enhanced risk to humans as a consequence of empirically determined lower moist heat stress tolerance. Proc Natl Acad Sci U S A 2023; 120:e2305427120. [PMID: 37812703 PMCID: PMC10589700 DOI: 10.1073/pnas.2305427120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/15/2023] [Indexed: 10/11/2023] Open
Abstract
As heatwaves become more frequent, intense, and longer-lasting due to climate change, the question of breaching thermal limits becomes pressing. A wet-bulb temperature (Tw) of 35 °C has been proposed as a theoretical upper limit on human abilities to biologically thermoregulate. But, recent-empirical-research using human subjects found a significantly lower maximum Tw at which thermoregulation is possible even with minimal metabolic activity. Projecting future exposure to this empirical critical environmental limit has not been done. Here, using this more accurate threshold and the latest coupled climate model results, we quantify exposure to dangerous, potentially lethal heat for future climates at various global warming levels. We find that humanity is more vulnerable to moist heat stress than previously proposed because of these lower thermal limits. Still, limiting warming to under 2 °C nearly eliminates exposure and risk of widespread uncompensable moist heatwaves as a sharp rise in exposure occurs at 3 °C of warming. Parts of the Middle East and the Indus River Valley experience brief exceedances with only 1.5 °C warming. More widespread, but brief, dangerous heat stress occurs in a +2 °C climate, including in eastern China and sub-Saharan Africa, while the US Midwest emerges as a moist heat stress hotspot in a +3 °C climate. In the future, moist heat extremes will lie outside the bounds of past human experience and beyond current heat mitigation strategies for billions of people. While some physiological adaptation from the thresholds described here is possible, additional behavioral, cultural, and technical adaptation will be required to maintain healthy lifestyles.
Collapse
Affiliation(s)
- Daniel J. Vecellio
- Center for Healthy Aging, Pennsylvania State University, University Park, PA16802
| | - Qinqin Kong
- Earth, Atmospheric, and Planetary Sciences Department and the Institute for a Sustainable Future, Purdue University, West Lafayette, IN47907
| | - W. Larry Kenney
- Center for Healthy Aging, Pennsylvania State University, University Park, PA16802
- Department of Kinesiology, Pennsylvania State University, University Park, PA16802
- Graduate Program in Physiology, Pennsylvania State University, University Park, PA16802
| | - Matthew Huber
- Earth, Atmospheric, and Planetary Sciences Department and the Institute for a Sustainable Future, Purdue University, West Lafayette, IN47907
| |
Collapse
|
22
|
Powis CM, Byrne D, Zobel Z, Gassert KN, Lute AC, Schwalm CR. Observational and model evidence together support wide-spread exposure to noncompensable heat under continued global warming. SCIENCE ADVANCES 2023; 9:eadg9297. [PMID: 37682995 PMCID: PMC10491292 DOI: 10.1126/sciadv.adg9297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/28/2023] [Indexed: 09/10/2023]
Abstract
As our planet warms, a critical research question is when and where temperatures will exceed the limits of what the human body can tolerate. Past modeling efforts have investigated the 35°C wet-bulb threshold, proposed as a theoretical upper limit to survivability taking into account physiological and behavioral adaptation. Here, we conduct an extreme value theory analysis of weather station observations and climate model projections to investigate the emergence of an empirically supported heat compensability limit. We show that the hottest parts of the world already experience these heat extremes on a limited basis and that under moderate continued warming parts of every continent, except Antarctica, will see a rapid increase in their extent and frequency. To conclude, we discuss the consequences of the emergence of this noncompensable heat and the need for incorporating different critical thermal limits into heat adaptation planning.
Collapse
Affiliation(s)
- Carter M. Powis
- Environmental Change Institute, University of Oxford, Oxford, UK
| | - David Byrne
- Woodwell Climate Research Center, Woods Hole, Falmouth, MA, USA
| | - Zachary Zobel
- Woodwell Climate Research Center, Woods Hole, Falmouth, MA, USA
| | | | - A. C. Lute
- Woodwell Climate Research Center, Woods Hole, Falmouth, MA, USA
| | | |
Collapse
|
23
|
Timpka S, Melander O, Engström G, Elmståhl S, Nilsson PM, Lind L, Pihlsgård M, Enhörning S. Short-term association between outdoor temperature and the hydration-marker copeptin: a pooled analysis in five cohorts. EBioMedicine 2023; 95:104750. [PMID: 37556945 PMCID: PMC10432996 DOI: 10.1016/j.ebiom.2023.104750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Whereas outdoor temperature is linked to both mortality and hydration status, the hormone vasopressin, measured through the surrogate copeptin, is a marker of cardiometabolic risk and hydration. We recently showed that copeptin has a seasonal pattern with higher plasma concentration in winter. Here, we aimed to investigate the association between outdoor temperature and copeptin. METHODS Copeptin was analysed in fasting plasma from five cohorts in Malmö, Sweden (n = 26,753, 49.7% men, age 18-86 years). We utilized a multivariable adjusted non-linear spline model with four knots to investigate the association between short-term temperature (24 h mean apparent) and log copeptin z-score. FINDINGS We found a distinct non-linear association between temperature and log copeptin z-score, with both moderately low and high temperatures linked to higher copeptin concentration (p < 0.0001). Between 0 °C and nadir at the 75th temperature percentile (corresponding to 14.3 °C), log copeptin decreased 0.13 z-scores (95% CI 0.096; 0.16), which also inversely corresponded to the increase in z-score log copeptin between the nadir and 21.3 °C. INTERPRETATION The J-shaped association between short-term temperature and copeptin resembles the J-shaped association between temperature and mortality. Whereas the untangling of temperature from other seasonal effects on hydration warrants further study, moderately increased water intake constitutes a feasible intervention to lower vasopressin and might mitigate adverse health effects of both moderately cold and hot outdoor temperatures. FUNDING Swedish Research Council, Å Wiberg, M Stephen, A Påhlsson, Crafoord and Swedish Heart-Lung Foundations, Swedish Society for Medical Research and Swedish Society of Medicine.
Collapse
Affiliation(s)
- Simon Timpka
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University, Malmö, Sweden
| | - Peter M Nilsson
- Internal Medicine - Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Pihlsgård
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Sofia Enhörning
- Perinatal and Cardiovascular Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
| |
Collapse
|
24
|
Lo YTE, Mitchell DM, Buzan JR, Zscheischler J, Schneider R, Mistry MN, Kyselý J, Lavigne É, da Silva SP, Royé D, Urban A, Armstrong B, Gasparrini A, Vicedo‐Cabrera AM. Optimal heat stress metric for modelling heat-related mortality varies from country to country. INTERNATIONAL JOURNAL OF CLIMATOLOGY : A JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY 2023; 43:5553-5568. [PMID: 37874919 PMCID: PMC10410159 DOI: 10.1002/joc.8160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 10/26/2023]
Abstract
Combined heat and humidity is frequently described as the main driver of human heat-related mortality, more so than dry-bulb temperature alone. While based on physiological thinking, this assumption has not been robustly supported by epidemiological evidence. By performing the first systematic comparison of eight heat stress metrics (i.e., temperature combined with humidity and other climate variables) with warm-season mortality, in 604 locations over 39 countries, we find that the optimal metric for modelling mortality varies from country to country. Temperature metrics with no or little humidity modification associates best with mortality in ~40% of the studied countries. Apparent temperature (combined temperature, humidity and wind speed) dominates in another 40% of countries. There is no obvious climate grouping in these results. We recommend, where possible, that researchers use the optimal metric for each country. However, dry-bulb temperature performs similarly to humidity-based heat stress metrics in estimating heat-related mortality in present-day climate.
Collapse
Affiliation(s)
- Y. T. Eunice Lo
- School of Geographical SciencesUniversity of BristolBristolUK
- Cabot Institute for the EnvironmentUniversity of BristolBristolUK
| | - Dann M. Mitchell
- School of Geographical SciencesUniversity of BristolBristolUK
- Cabot Institute for the EnvironmentUniversity of BristolBristolUK
| | - Jonathan R. Buzan
- Climate and Environmental Physics, Physics InstituteUniversity of BernBernSwitzerland
- Oeschger Center for Climate Change ResearchUniversity of BernBernSwitzerland
| | - Jakob Zscheischler
- Department of Computational HydrosystemsHelmholtz Centre for Environmental Research GmbH—UFZLeipzigGermany
| | - Rochelle Schneider
- Ф‐LabEuropean Space Agency (ESA‐ESRIN)FrascatiItaly
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Centre on Climate Change & Planetary HealthLondon School of Hygiene and Tropical MedicineLondonUK
- Forecast DepartmentEuropean Centre for Medium‐Range Weather Forecast (ECMWF)ReadingUK
| | - Malcolm N. Mistry
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Department of EconomicsCa' Foscari University of VeniceVeniceItaly
| | - Jan Kyselý
- Institute of Atmospheric PhysicsCzech Academy of SciencesPragueCzech Republic
- Faculty of Environmental SciencesCzech University of Life SciencesPragueCzech Republic
| | - Éric Lavigne
- School of Epidemiology & Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
- Air Health Science DivisionHeatlh CanadaOttawaCanada
| | | | - Dominic Royé
- Climate Research Foundation (FIC)MadridSpain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP)Spain
| | - Aleš Urban
- Institute of Atmospheric PhysicsCzech Academy of SciencesPragueCzech Republic
- Faculty of Environmental SciencesCzech University of Life SciencesPragueCzech Republic
| | - Ben Armstrong
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | | | - Antonio Gasparrini
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Centre on Climate Change & Planetary HealthLondon School of Hygiene and Tropical MedicineLondonUK
- Centre for Statistical MethodologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Ana M. Vicedo‐Cabrera
- Oeschger Center for Climate Change ResearchUniversity of BernBernSwitzerland
- Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
| |
Collapse
|
25
|
Simpson CH, Brousse O, Ebi KL, Heaviside C. Commonly used indices disagree about the effect of moisture on heat stress. NPJ CLIMATE AND ATMOSPHERIC SCIENCE 2023; 6:s41612-023-00408-0. [PMID: 38204467 PMCID: PMC7615504 DOI: 10.1038/s41612-023-00408-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/25/2023] [Indexed: 01/12/2024]
Abstract
Irrigation and urban greening can mitigate extreme temperatures and reduce adverse health impacts from heat. However, some recent studies suggest these interventions could actually exacerbate heat stress by increasing humidity. These studies use different heat stress indices (HSIs), hindering intercomparisons of the relative roles of temperature and humidity. Our method uses calculus of variations to compare the sensitivity of HSIs to temperature and humidity, independent of HSI units. We explain the properties of different HSIs and identify conditions under which they disagree. We highlight recent studies where the use of different HSIs could have led to opposite conclusions. Our findings have significant implications for the evaluation of irrigation and urban greening as adaptive responses to overheating and climate adaptation measures in general. We urge researchers to be critical in their choice of HSIs, especially in relation to health outcomes; our method provides a useful tool for making informed comparisons.
Collapse
Affiliation(s)
- Charles H. Simpson
- Institute of Environmental Design and Engineering, Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London, UK
| | - Oscar Brousse
- Institute of Environmental Design and Engineering, Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London, UK
| | - Kristie L. Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA USA
| | - Clare Heaviside
- Institute of Environmental Design and Engineering, Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London, UK
| |
Collapse
|
26
|
Baldwin JW, Benmarhnia T, Ebi KL, Jay O, Lutsko NJ, Vanos JK. Humidity's Role in Heat-Related Health Outcomes: A Heated Debate. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:55001. [PMID: 37255302 PMCID: PMC10231239 DOI: 10.1289/ehp11807] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND As atmospheric greenhouse gas concentrations continue to rise, temperature and humidity will increase further, causing potentially dire increases in human heat stress. On physiological and biophysical grounds, exposure to higher levels of humidity should worsen heat stress by decreasing sweat evaporation. However, population-scale epidemiological studies of heat exposure and response often do not detect associations between high levels of humidity and heat-related mortality or morbidity. These divergent, disciplinary views regarding the role of humidity in heat-related health risks limit confidence in selecting which interventions are effective in reducing health impacts and in projecting future heat-related health risks. OBJECTIVES Via our multidisciplinary perspective we seek to a) reconcile the competing realities concerning the role of humidity in heat-related health impacts and b) help ensure robust projections of heat-related health risks with climate change. These objectives are critical pathways to identify and communicate effective approaches to cope with present and future heat challenges. DISCUSSION We hypothesize six key reasons epidemiological studies have found little impact of humidity on heat-health outcomes: a) At high temperatures, there may be limited influence of humidity on the health conditions that cause most heat-related deaths (i.e., cardiovascular collapse); b) epidemiological data sets have limited spatial extent, a bias toward extratropical (i.e., cooler and less humid), high-income nations, and tend to exist in places where temporal variations in temperature and humidity are positively correlated; c) analyses focus on older, vulnerable populations with sweating, and thus evaporative, impairments that may be further aggravated by dehydration; d) extremely high levels of temperature and humidity (seldom seen in the historical record) are necessary for humidity to substantially impact heat strain of sedentary individuals; e) relationships between temperature and humidity are improperly considered when interpreting epidemiological model results; and f) sub-daily meteorological phenomena, such as rain, occur at high temperatures and humidity, and may bias epidemiological studies based on daily data. Future research must robustly test these hypotheses to advance methods for more accurate incorporation of humidity in estimating heat-related health outcomes under present and projected future climates. https://doi.org/10.1289/EHP11807.
Collapse
Affiliation(s)
- Jane W. Baldwin
- Department of Earth System Science, University of California, Irvine, Irvine, California, USA
- Lamont-Doherty Earth Observatory, Palisades, New York, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, USA
| | - Kristie L. Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Nicholas J. Lutsko
- Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, USA
| | - Jennifer K. Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona, USA
| |
Collapse
|
27
|
Wolf ST, Havenith G, Kenney WL. Relatively minor influence of individual characteristics on critical wet-bulb globe temperature (WBGT) limits during light activity in young adults (PSU HEAT Project). J Appl Physiol (1985) 2023; 134:1216-1223. [PMID: 36995912 PMCID: PMC10211460 DOI: 10.1152/japplphysiol.00657.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Critical environmental limits are temperature-humidity thresholds above which heat balance cannot be maintained for a given metabolic heat production. This study examined the association between individual characteristics [sex, body surface area (AD), aerobic capacity (V̇o2max), and body mass (mb)] and critical environmental limits in young adults at low metabolic rates. Forty-four (20 M/24 F; 23 ± 4 yr) subjects were exposed to progressive heat stress in an environmental chamber at two low net metabolic rates (Mnet); minimal activity (MinAct; Mnet = ∼160 W) and light ambulation (LightAmb; Mnet = ∼260 W). In two hot-dry (HD; ≤25% rh) environments, ambient water vapor pressure (Pa = 12 or 16 mmHg) was held constant and dry-bulb temperature (Tdb) was systematically increased. In two warm-humid (WH; ≥50% rh) environments, Tdb was held constant at 34°C or 36°C, and Pa was systematically increased. The critical wet-bulb globe temperature (WBGTcrit) was determined for each condition. During MinAct, after entry of Mnet into the forward stepwise linear regression model, no individual characteristics were entered into the model for WH (R2adj = 0.01, P = 0.27) or HD environments (R2adj = -0.01, P = 0.44). During LightAmb, only mb was entered into the model for WH environments (R2adj = 0.44, P < 0.001), whereas only V̇o2max was entered for HD environments (R2adj = 0.22; P = 0.002). These data demonstrate negligible importance of individual characteristics on WBGTcrit during low-intensity nonweight-bearing (MinAct) activity with a modest impact of mb and V̇o2max during weight-bearing (LightAmb) activity in extreme thermal environments.NEW & NOTEWORTHY Our laboratory has recently published a series of papers establishing the upper ambient temperature-humidity thresholds for maintaining heat balance, termed critical environmental limits, in young adults. However, no studies have investigated the relative influence of individual characteristics, such as sex, body size, and aerobic fitness, on those environmental limits. Here, we demonstrate the contributions of sex, body mass, body surface area, and maximal aerobic capacity on critical wet-bulb globe temperature (WBGT) limits in young adults.
Collapse
Affiliation(s)
- S Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - W Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| |
Collapse
|
28
|
Cvijanovic I, Mistry MN, Begg JD, Gasparrin A, Rodó X. Importance of humidity for characterization and communication of dangerous heatwave conditions. NPJ CLIMATE AND ATMOSPHERIC SCIENCE 2023; 6:s41612-023-00346-x. [PMID: 37252185 PMCID: PMC7614577 DOI: 10.1038/s41612-023-00346-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/09/2023] [Indexed: 05/31/2023]
Abstract
Heatwaves are one of the leading causes of climate-induced mortality. Using the examples of recent heatwaves in Europe, the United States and Asia, we illustrate how the communication of dangerous conditions based on temperature maps alone can lead to insufficient societal perception of health risks. Comparison of maximum daily values of temperature with physiological heat stress indices accounting for impacts of both temperature and humidity, illustrates substantial differences in geographical extent and timing of their respective peak values during these recent events. This signals the need to revisit how meteorological heatwaves and their expected impacts are communicated. Close collaboration between climate and medical communities is needed to select the best heat stress indicators, establish them operationally, and introduce them to the public. npj Climate and Atmospheric Science (2023) 6:33.
Collapse
Affiliation(s)
- Ivana Cvijanovic
- Barcelona Institute for Global Health - ISGLOBAL, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Malcolm N. Mistry
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH London, United Kingdom
- Department of Economics, Ca’ Foscari University of Venice, Cannaregio 873/b, 30121 Venice, Italy
| | - James D. Begg
- The University of Manchester, Department of Earth and Environmental Sciences, Oxford Road, M13 9PL Manchester, United Kingdom
| | - Antonio Gasparrin
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH London, United Kingdom
- The Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH London, United Kingdom
| | - Xavier Rodó
- Barcelona Institute for Global Health - ISGLOBAL, Doctor Aiguader 88, 08003 Barcelona, Spain
- ICREA, Passeig Lluís Companys 23, 08010 Barcelona, Spain
| |
Collapse
|
29
|
Lu YC, Romps DM. Predicting fatal heat and humidity using the heat index model. J Appl Physiol (1985) 2023; 134:649-656. [PMID: 36701484 PMCID: PMC10010916 DOI: 10.1152/japplphysiol.00417.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
A unique wet-bulb temperature of 35°C is often used as the threshold for human survivability, but recent experiments have shown that a person's core temperature starts to rise at a wide range of critical wet-bulb temperatures. Here, it is shown that the model underlying the heat index correctly predicts those critical wet-bulb temperatures, explaining 95% of the variance in the values observed in laboratory heat-stress experiments. This is the first time the heat-index model has been validated against physiological data from laboratory experiments. For light and moderate exertion in an indoor setting, the heat index model predicts that the critical wet-bulb temperature ranges from 20°C to 32°C, depending on the relative humidity, consistent with experimental results. For the same setting and exertion, the heat index model predicts fatal wet-bulb temperatures ranging from 24°C to 37°C.NEW & NOTEWORTHY Recent experiments have identified the critical combinations of heat and humidity, in an indoor setting, above which an individual is unable to maintain a standard core temperature, indicating severe heat stress. It is shown here why this state of severe heat stress cannot be predicted using the wet-bulb temperature. Instead, it is shown that the recently extended heat index model can explain nearly all of the variance in the observed critical combinations of temperature and humidity, and can be used to calculate fatal combinations.
Collapse
Affiliation(s)
- Yi-Chuan Lu
- Department of Physics, University of California, Berkeley, California, United States
- Climate and Ecosystem Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States
| | - David M Romps
- Climate and Ecosystem Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States
- Department of Earth and Planetary Science, University of California, Berkeley, California, United States
| |
Collapse
|
30
|
Wolf ST, Vecellio DJ, Kenney WL. Adverse heat-health outcomes and critical environmental limits (Pennsylvania State University Human Environmental Age Thresholds project). Am J Hum Biol 2023; 35:e23801. [PMID: 36125292 PMCID: PMC9840654 DOI: 10.1002/ajhb.23801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The earth's climate is warming and the frequency, duration, and severity of heat waves are increasing. Meanwhile, the world's population is rapidly aging. Epidemiological data demonstrate exponentially greater increases in morbidity and mortality during heat waves in adults ≥65 years. Laboratory data substantiate the mechanistic underpinnings of age-associated differences in thermoregulatory function. However, the specific combinations of environmental conditions (i.e., ambient temperature and absolute/relative humidity) above which older adults are at increased risk of heat-related morbidity and mortality are less clear. METHODS This review was conducted to (1) examine the recent (past 3 years) literature regarding heat-related morbidity and mortality in the elderly and discuss projections of future heat-related morbidity and mortality based on climate model data, and (2) detail the background and unique methodology of our ongoing laboratory-based projects aimed toward identifying the specific environmental conditions that result in elevated risk of heat illness in older adults, and the implications of using the data toward the development of evidence-based safety interventions in a continually-warming climate (PSU HEAT; Human Environmental Age Thresholds). RESULTS The recent literature demonstrates that extreme heat continues to be increasingly detrimental to the health of the elderly and that this is apparent across the world, although the specific environmental conditions above which older adults are at increased risk of heat-related morbidity and mortality remain unclear. CONCLUSION Characterizing the environmental conditions above which risk of heat-related illnesses increase remains critical to enact policy decisions and mitigation efforts to protect vulnerable people during extreme heat events.
Collapse
Affiliation(s)
- S. Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
| | - Daniel J. Vecellio
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
| | - W. Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
- Graduate Program in Physiology, The Pennsylvania State University, University Park, PA, 16802
| |
Collapse
|
31
|
Guzman-Echavarria G, Middel A, Vanos J. Beyond heat exposure - new methods to quantify and link personal heat exposure, stress, and strain in diverse populations and climates: The journal Temperature toolbox. Temperature (Austin) 2022; 10:358-378. [PMID: 37554380 PMCID: PMC10405775 DOI: 10.1080/23328940.2022.2149024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/21/2022] Open
Abstract
Fine-scale personal heat exposure (PHE) information can help prevent or minimize weather-related deaths, illnesses, and reduced work productivity. Common methods to estimate heat risk do not simultaneously account for the intensity, frequency, and duration of thermal exposures, nor do they include inter-individual factors that modify physiological response. This study demonstrates new whole-body net thermal load estimations to link PHE to heat stress and strain over time. We apply a human-environment heat exchange model to examine how time-varying net thermal loads differ across climate contexts, personal attributes, and spatiotemporal scales. First, we investigate summertime climatic PHE impacts for three US cities: Phoenix, Miami, and New York. Second, we model body morphology and acclimatization for three profiles (middle-aged male/female; female >65 years). Finally, we quantify model sensitivity using representative data at synoptic and micro-scales. For all cases, we compare required and potential evaporative heat losses that can lead to dangerous thermal exposures based on (un)compensable heat stress. Results reveal misclassifications in heat stress or strain due to incomplete environmental data and assumed equivalent physiology and activities between people. Heat strain is most poorly represented by PHE alone for the elderly, non-acclimatized, those engaged in strenuous activities, and when negating solar radiation. Moreover, humid versus dry heat across climates elicits distinct thermal responses from the body. We outline criteria for inclusive PHE evaluations connecting heat exposure, stress, and strain while using physiological-based methods to avoid misclassifications. This work underlines the value of moving from "one-size-fits-all" thermal indices to "fit-for-purpose" approaches using personalized information.
Collapse
Affiliation(s)
- Gisel Guzman-Echavarria
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Ariane Middel
- School of Arts, Media and Engineering, Arizona State University, Tempe, AZ, USA
- School of Computing and Augmented Intelligence, Arizona State University,Tempe, AZ, USA
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
32
|
Kenney WL, Havenith G, Jay O. Thermal physiology, more relevant than ever before. J Appl Physiol (1985) 2022; 133:676-678. [PMID: 35981733 DOI: 10.1152/japplphysiol.00464.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- W Larry Kenney
- Physiology Program and Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Leics, United Kingdom
| | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
33
|
Vecellio DJ, Wolf ST, Cottle RM, Kenney WL. Utility of the Heat Index in defining the upper limits of thermal balance during light physical activity (PSU HEAT Project). INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1759-1769. [PMID: 35778555 PMCID: PMC9418276 DOI: 10.1007/s00484-022-02316-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/07/2022] [Accepted: 06/18/2022] [Indexed: 06/01/2023]
Abstract
Extreme heat events and consequent detrimental heat-health outcomes have been increasing in recent decades and are expected to continue with future climate warming. While many indices have been created to quantify the combined atmospheric contributions to heat, few have been validated to determine how index-defined heat conditions impact human health. However, this subset of indices is likely not valid for all situations and populations nor easily understood and interpreted by health officials and the public. In this study, we compare the ability of thresholds determined from the National Weather Service's (NWS) Heat Index (HI), the Wet Bulb Globe Temperature (WBGT), and the Universal Thermal Climate Index (UTCI) to predict the compensability of human heat stress (upper limits of heat balance) measured as part of the Pennsylvania State University's Heat Environmental Age Thresholds (PSU HEAT) project. While the WBGT performed the best of the three indices for both minimal activities of daily living (MinAct; 83 W·m-2) and light ambulation (LightAmb; 133 W·m-2) in a cohort of young, healthy subjects, HI was likewise accurate in predicting heat stress compensability in MinAct conditions. HI was significantly correlated with subjects' perception of temperature and humidity as well as their body core temperature, linking perception of the ambient environment with physiological responses in MinAct conditions. Given the familiarity the public has with HI, it may be better utilized in the expansion of safeguard policies and the issuance of heat warnings during extreme heat events, especially when access to engineered cooling strategies is unavailable.
Collapse
Affiliation(s)
- Daniel J Vecellio
- Center for Health Aging, College of Health and Human Development, Pennsylvania State University, 422 Biobehavioral Health Building, University Park, PA, 16802, USA.
| | - S Tony Wolf
- Department of Kinesiology, Pennsylvania State University, University Park, PA, 16802, USA
| | - Rachel M Cottle
- Department of Kinesiology, Pennsylvania State University, University Park, PA, 16802, USA
| | - W Larry Kenney
- Center for Health Aging, College of Health and Human Development, Pennsylvania State University, 422 Biobehavioral Health Building, University Park, PA, 16802, USA
- Department of Kinesiology, Pennsylvania State University, University Park, PA, 16802, USA
- Graduate Program in Physiology, Pennsylvania State University, University Park, PA, 16802, USA
| |
Collapse
|
34
|
Dee SG, Nabizadeh E, Nittrouer CL, Baldwin JW, Li C, Gaviria L, Guo S, Lu K, Saunders‐Shultz BM, Gurwitz E, Samarth G, Weinberger KR. Increasing Health Risks During Outdoor Sports Due To Climate Change in Texas: Projections Versus Attitudes. GEOHEALTH 2022; 6:e2022GH000595. [PMID: 36254118 PMCID: PMC9363732 DOI: 10.1029/2022gh000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
Extreme heat is a recognized threat to human health. This study examines projected future trends of multiple measures of extreme heat across Texas throughout the next century, and evaluates the expected climate changes alongside Texas athletic staff (coach and athletic trainer) attitudes toward heat and climate change. Numerical climate simulations from the recently published Community Earth System Model version 2 and the Climate Model Intercomparison Project were used to predict changes in summer temperatures, heat indices, and wet bulb temperatures across Texas and also within specific metropolitan areas. A survey examining attitudes toward the effects of climate change on athletic programs and student athlete health was also distributed to high-school and university athletic staff. Heat indices are projected to increase beyond what is considered healthy/safe limits for outdoor sports activity by the mid-to-late 21st century. Survey results reveal a general understanding and acceptance of climate change and a need for adjustments in accordance with more dangerous heat-related events. However, a portion of athletic staff still do not acknowledge the changing climate and its implications for student athlete health and their athletic programs. Enhancing climate change and health communication across the state may initiate important changes to athletic programs (e.g., timing, duration, intensity, and location of practices), which should be made in accordance with increasingly dangerous temperatures and weather conditions. This work employs a novel interdisciplinary approach to evaluate future heat projections alongside attitudes from athletic communities toward climate change.
Collapse
Affiliation(s)
- Sylvia G. Dee
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | | | | | - Jane W. Baldwin
- Department of Earth System ScienceUniversity of California IrvineIrvineCAUSA
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
| | - Chelsea Li
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Lizzy Gaviria
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Selena Guo
- Department of EconomicsRice UniversityHoustonTXUSA
| | - Karen Lu
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | | | - Emily Gurwitz
- Stanford University School of Humanities and SciencesPalo AltoCAUSA
| | - Gargi Samarth
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Kate R. Weinberger
- School of Population and Public HealthThe University of British ColumbiaVancouverBCCanada
| |
Collapse
|